Amazing Breech Birth in Hospital

The path to Jennifer’s birth started at 32 weeks. I had a scan which showed that baby was growing well but that she was breech. This was not great news, particularly as we had been hoping for a home birth. We had had a positive experience of a hospital birth with our son, Pete, now two and a half, using hypnobirthing, so we had been very keen to go for a home birth this time round. While the general advice was that there was still plenty of time for baby to turn, I embarked on the process of actively encouraging her to turn. After about a week, I thought that she had (although in hindsight realised that I would have definitely felt something significant had she rotated), so at my 36 week scan, I was surprise to find out that she hadn’t. At this appointment, I was alone, as my husband, Ciaran. needed to stay at home to care for our sick son. My consultant matter of factly informed me that if the baby did not turn I ‘would not pass go’ and it would be a section. I asked if I could have a scan the following week and initially she declined but then, probably feeling sorry for me, agreed to one.

Amongst the people I phoned that morning was a friend who was an acupuncturist and he scheduled me in for later that day to start a course of moxa. Over the course of that week I attended for several moxa sessions and spent the week engaging in any activity which would encourage baby to turn, including visualisation, hypnosis, inversions and even hand stands in the pool. After a few days I was convinced that there had been some movement in the direction of transverse. The following week, I sat waiting for the scan, quietly chanting my birth affirmations, with a particular focus on those relating to the baby turning, while I gazed at a well worn picture of a baby in the perfect head down position.

On reflection, I realised that these efforts were like saying the rosary in an effort to induce a miracle, which deep down I knew wasn’t going to happen. After about half an hour of waiting, I got my answer, baby was still breech, hadn’t moved an inch. I asked the sonographer about the possibility of getting an External Cephalic Version (ECV), and she said that she thought that it could be done, but that I’d need to get an appointment with one of the doctors in order to discuss this. Later that morning I met with the registrar that I was under, and she arranged an appointment with one of the few consultants who conducted this procedure, scheduled for the following Monday, the day before I hit week 38.

In the days leading up to this, I went through a whirlwind of emotions, and had to work through the very real possibility of a section, either as a risk factor from the ECV or as the likely outcome if the ECV was unsuccessful. Over this time I became well informed regarding breech presentation and options regarding delivery. The key facts that I learned regarding breech delivery were that a natural breech birth was best for mother and baby once it proceeded without any augmentation of labour or direct intervention, and that if labour wasn’t progressing well that a section was the safest option at this point.

It was a tough couple of days. I got so much support from a range of people, both personal and professional, and that really enabled me to have the strength to work through this process. By the Monday, I was in a space where I had made peace with where baby was at, and had changed one of my affirmations from ‘baby is in the perfect head down position’ to ‘baby is in the perfect position for being born safely’. I went to the hospital with a determination to fight for a natural breech delivery, should the ECV be unsuccessful.

From that Monday the path towards labour changed. The consultant decided against carrying out the ECV as the cord was too close to baby’s neck. While my initial reaction was disappointment, it was immediately followed by relief, as it now explained why baby hadn’t turned given all my efforts. As I sat up anticipating having to fight my corner, the consultant gave me the option of a natural delivery on the basis of labour progressing well. Both Ciaran and I were in disbelief at this positive outcome, and asked him to write down his recommendations in my file, which he dutifully did, with specific instructions to contact him should he be needed.

I felt calmer than I had in weeks, this all felt right, and so I now focused my energies on preparing for a breech birth. Ironically at my regular appointments at week 38 with my registrar and 39 with my consultant, they both now supported the idea of a natural delivery, which just showed the effect of having a ‘God consultant’ write in my file…perhaps my rosary chanting had actually worked!

Sunday 28th November…started to snow, 11.30

I had an early night, as I had a real concern about going into labour in the middle of the night, and the disruption that this would be for Pete. Ciaran came to bed some time after one with a weather report…I wouldn’t be going to my osteopath appointment in the morning…what does he know that I don’t, I thought, and then he explained that it had started snowing. I looked out the window and it was a winter wonderland, and the snow was continuing to fall. He joined me in the bed and soon my brain began to race. The energy of both of our brains going into overdrive kept us both awake. You see we live in a small townland, at the bottom of a valley, with steep hills on either side. The roads had been treacherous following snowfall last winter, so being snowbound was a real issue. Shall we relocate to friends near the city in the morning….yes was the definite response.

I struggled with sleeping, my brain going through so many possibilities, while at the same time sending baby a strong message that this was definitely not the time to start arriving as it wasn’t safe. Soon after the weather report, I started to feel constipated, not particularly bad, but enough to have me feeling a bit uncomfortable, and contributing to my insomnia. Ciaran eventually gave up trying to sleep and got up to watch some TV. I listened to my hypnosis tracks for a while but for a change they did not induce sleep. I then flicked through some TV and was still awake when Ciaran came back to bed some time later. Despite the thoughts and our concerns, I still had an overall feeling of calmness, and eventually nodded off to sleep.

Monday 29th November

We woke up and yes there was still plenty of snow. We made plans to get ourselves relocated and later that day, having driven up our hill, attached to a tractor as a safety line, we made it to our refuge, where there was only a light dusting of snow. While Ciaran got on with trying to get a bit of a day’s work in, Pete and I hung out with his almost 2 year old friend and his mother for the afternoon. It was such a weight off our minds to be in a safe place…and now that we were there, my body felt safe to go into labour, following the visualisations of my ideal birth.

In the weeks coming up to labour, I frequently visualised my ideal birth, and while specific details varied, there were a number of key elements to my ideal birth visualisation. Firstly, I’d know when to go to the hospital, and that we would get to the hospital safely. This generally ran alongside the visualisation of our son, Pete being OK, and happily saying goodbye to us as we went to the hospital. I then pictured a gentle, strong labour, as I knew that baby needed to be delivered by me with as little intervention as possible. I pictured my labour being quite private, that the staff wouldn’t know how fast I was progressing …essentially sneaking up on them by surprise before they could start intervening. I pictured a fast second stage, and finally I pictured walking up to the recovery room, a clear sign that I had not had a section. Amazingly, it all unfolded to plan….

I’ll know when to go to the hospital

We sat down to dinner and at around 7pm, just as I was about to have seconds, my waters broke. Ciaran was drawn away from an in-depth discussion with Pete about cheese, to follow me into the bathroom, where we confirmed that yes it was definitely time to get moving.

Our little boy will be OK.

I told Pete that it was time for Mammy and Daddy to go to the hospital and that our friends would mind him. We chatted for a few minutes then he gave me a kiss and kissed baby and very soon we were off.

The drive to the hospital was quite surreal. It was a calm drive, there was no panic, no need to rush. I felt mild cramp-like pains every now and again. Checking through my hospital bag in my head I soon realised that I didn’t have my mp3 player which contained the ‘Book of Tracy’…in addition to a selection of music that I had hoped to access…hmm could I go through labour without it…yes….no…yes….no turn around…no…needed to keep moving forward, so we dispatched our friend to bring it in to us.

We arrived at the reception, waiting while the male receptionist finished chatting to someone. “I’m in labour,” I informed him. He seemed bemused that I was saying this like I was here for my hair dressers appointment. We were directed to the waiting area for the emergency room. C went to park the car and I sat and waited. Some soaps were on the T.V. There were two people ahead of me. I passed the time snacking on granola bars and water, and taking occasional trips to the toilet. A nurse came out to ask if I was OK to wait. I told her that I was, but checked that she knew that baby was breech. She said that she did.

C. came back with bag and pillows. A few minutes later our ‘courier’ had arrived with my essential mp3 player. After about a half our wait, I was called to be seen, and C. was able to come with me (so much better than our previous hospital experience when partners were not permitted in the emergency room).

I was hooked up to the continuous fetal monitor and was asked to press a button when the baby moved…I pressed it a bit randomly, as it was difficult to distinguish a movement from a surge, and in my previous labour I had been asked to press the same button when I felt a contraction. A midwife put a line in, which I found uncomfortable both physically and psychologically. While she did not explicitly state it, she was essentially carrying out initial preparations for a section. Nurses came in from time to time, concern was expressed that the trace was not indicating much movement, and so was checked by a doctor, who had no concerns and a few minutes later apparently it was all fine. C. had a glance at the trace and didn’t see any change in the readings for the duration, so there appeared to be a bit of fuss over nothing. The doctor outlined that we would need to see how the trace was going, that this would be the starting point regarding whether or not we could proceed with a natural delivery. I had an internal exam and was found to be only 1cm dilated yet fully effaced. This felt a bit disappointing but I knew it wouldn’t help to focus on the numbers game.

The consultant on call arrived, with the greeting of “hi I’m your consultant handshake”…I struggled to send the body language that I was to be an equal participant in a discussion…despite being hooked up to a machine that goes ‘bing’ and being semi reclined. So, the dialogue went roughly as follows… “So, why do you want to have a natural delivery?”…polite smiles from both of us…polite response by me about it being the ideal for baby and I (given that all would be going well)…no actually a caesarean would be the safest for baby…polite smiles from us both.

… “& how many children and you planning to have?”…I saw C.’s body rise up in the seat

“Why do you ask?”…I was not in a space for indirect conversations, “well essentially if this is your last then a section would be the best option, but if not then a natural birth would be more favourable for a future pregnancy.”

Polite smiles…file and box that information and put it high on a shelf….

He then said he’d monitor my progress and we’d see how we go. I stated my preference for a supported squat for the second stage of labour…he interpreted this as me looking to go onto all fours. I smiled nicely (again) and explained how I wanted to use gravity to assist me and that it wouldn’t be that different from the lithotomy position…he essentially said… “there there we’ll talk about that if you get that far.”

He left…and a few minutes later C popped out and I took the opportunity to have one last opportunity to indulge my fear of a section. I spoke to baby about how this scared me but that we would do our best to have a natural delivery and that however it turned out, it would be OK…I then put these fears in a box on a similarly high shelf, as I went back to focusing on my birth story…with a particular focus of walking up to the ward after delivery.

A gentle, strong labour…sneaking up on them by surprise

We ended up being brought to the induction room at around 9.15, as this would be a place where I could be until labour ‘started to progress.’ It was a room with three others, where over the hum of machines there was the sound of one woman whimpering in the bed beside me. The time initially passed with answering standard questions, chatting with Ciaran and snacking. Ciaran popped out to get a coffee, a chance that he needed to make the most of whilst I was happy for him to leave. On several occasions I was asked to, “Let us know when the pains get stronger,” and I was sporadically given traces while I listened to some vocal music on my mp3 player. From 10.30 or so I found that the surges slowly became more intense, and that I was experiencing them as pain and discomfort. I found that I was drawn to images of water, of surfing the waves, but that, not being very good at it, I kept falling off the surfboard and getting washed over by a huge strong wave. The waves came in patterns of two, one wave which reached a high peak, the second a lower wave, but staying high longer. These waves I experienced as pain, initially breathing through them, focusing on keeping my body relaxed, opening hands, and moving them in swim-like motion, while actively focusing on my jaw relaxing as I breathed out. I found that I was most comfortable sitting on a chair, with my head on the side of the bed, propped up by some pillows. Having my feet flat on the floor felt quite grounding.

Around 11.00 or so, the pain intensified, surges becoming more frequent and stronger. I felt like I was climbing a cliff, nearly at the top, but struggling to get my hand to the last hand hold, and after a few struggles, would eventually get there, but never being sure if I could reach. Around 11.15 shiny shoes were spotted under the curtain, and the consultant stuck his head in…Are the pains getting stronger? Yes, I smiled politely before going back to my body.

Since we had arrived in the induction room I had made several trips to the toilet, and each time the trip became more arduous and resulted in more of my waters releasing. On this particular trip to the bathroom, I had a bowel movement, a sign, I knew, that things were progressing fast, a point of no return. Ciaran was waiting for me outside the door as I tried to time standing up and walking back to the bed before the next surge.

My voice became the outlet for my pain. What had started as a barely audible outbreath became a sigh, then a meditative ‘aw’, which then progressed to an animal like call. I found myself drawn to images of a wolf, as the surges became excruciatingly painful, and piling on top of each other. I started to make repeated sounds but then felt a sense of hyperventilation so focused on sustaining the primal sound coming out of my body. As the sounds coming from me intensified, I could feel baby getting lower in my body, feeling an urge to push but knowing that it was too soon. I gripped at and bit into the pillows in front of me. “Baby, we love you,” I sang.

I knew that I needed to experience a strong labour and had actively visualised this, and know found myself thinking, “and I wanted this!” I felt that I couldn’t go on, and I asked C. to tell me that I could do this. C. kept on reassuring me with what I needed to hear, with a mantra of you can do this, your body knows what to do. I sobbed to baby to give me a moment’s break...baby had other ideas.

As the midwives quickly realised that labour was progressing fast they wanted to continuously monitor me again, so they struggled to put the monitor around my waist, my body writhing like a caged animal as I lived through the surges. It didn’t take long for them to decide that I needed to go into the labour ward. I told them I couldn’t walk, as the surges were coming so close together, so they helped me onto a wheelchair as more of my waters released. I have a vivid image of being pushed along the corridor to the labour ward while gripping the chair with all my might, and making a lot of noise. I could feel the sensation of a refreshing breeze from the air passing my face. I bemusedly wondered how wild I must be appearing at this point and that there couldn’t have been anyone in the labour wing who didn’t hear me.

We got into the labour ward.

There was some mention of a gown, which I dismissed as I started to pull off the remaining clothes that I was wearing in response to a burning heat throughout my body. I climbed up on the bed and kneeled, facing the head of the bed, holding the top bed rail with all my might. Time for another trace, and this time an internal exam. In between surges I negotiated being able to stay in a supported squat or delivering the baby and the Registrar agreed to this, suggested weight bearing on the stirrups with my arms. Back to facing the head of the bed, lots of shouting in the background, yet over that, and my constant ‘ah’ I focused on C.’s voice as he continued to keep me assured that I was doing OK. Another check, an anterior lip, damn. I called to my body and baby to, “open” which I heard distantly echoed by one of the midwives.

I distinctly remember that Ciaran was the first person who told me to start to push, followed by a blurry chorus by others in the room. I now faced them, in a supported squat. Over the next 10 minutes or so, baby was delivered in three pushes. Given that during this time I was just focusing on staying alive and pushing, Ciaran told me afterwards how she came out. First push, out came the bottom and legs, second push out as far as her neck, which had the appearance of being very long. At this point, the Registrar rotated her body about 90 degrees and on the third push her head came out. The cord was quickly cut as she was immediately brought over to the baby doctor to be checked out…a few seconds later and a loud cry.

We did it, a little girl born at 00.59 on 30th November, her due date…a natural breech delivery…and yet all I could say was, “Am I alive?” My body was in shock, and while I never thought I was going to die, I did think that I might break with the pain. In contrast, the nurses and Registrar were busy congratulating me and celebrating how well I had done.

Our little girl, Jennifer, was placed on me soon afterwards, and I held her as they proceeded to manage the 3rd stage. I was then given stitches, I had torn again, unsurprising as I had torn during my first labour. The stitching felt like it took forever...was she darning a quilt? Eventually the poking and prodding was stopped and our little girl latched on strongly and started to feed…our beautiful little upside down girl.

Replies to This Discussion

Thank you for sharing your story Tracy! My son was also breech and I remember going through the emotional rollercoaster, dealing with the very real possibility of having a birth experience that was the complete opposite of what I had envisioned. I, too, did all the exercises, moxa, etc., and even had ECV, but to no avail. Fortunately, I was able to find the one doctor who would agree to a vaginal delivery, but natural it was not. I avoided a c-section and induction, but the doctor's condition for delivery was an epidural and episiotomy as well as lithotomy. I firmly believe that without an epidural and an episiotomy and being able to push in a squat position, my son and I would have experienced a very different outcome. My son was hypoxic at birth and spent some time in the NICU. He is now a healthy toddler, but does have gross motor delays. Although I had planned a waterbirth at a local birth center and vehemently fought for the birth I wanted (with the amazing help and support of the midwives at the birthcenter and friends/family), in the end, I felt cheated out of a more peaceful and healthier birth experience because of the current maternity care system and how it negatively impacts the experiences of even the most resourceful expectant mother. Your story has been an inspiration to me. Thank you and congratulations on your second precious baby!